<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
</head>

<body style="font-family:Arial, Helvetica, sans-serif">
<form id="form1" name="form1" method="post" action="/Repaircenter/emergency-staff-record">
<?php if(!$this->errorflag){?>
	
  Job ID:<?php echo $this->jobId;?> Shop: <?php echo $this->shopHead;?><br/><br/>
  Level of Days<br/>
  <select name = "lv_day" id = "lv_day">
  		<option selected="selected"  value = "" disabled>Please Select</option>
  		<option  value = "3" >3 Days</option>
  		<option  value = "7" >7 Days</option>
  </select>
  <br/><br/>Delivery Option<br/>
   <select name = "delivery" id = "delivery">
  		<option selected="selected"  value = "" disabled>Please Select</option>
  		<option  value = "Personal delivery" >Personal delivery</option>
  		<option  value = "Courier" >Courier</option>
  		<option  value = "Express post" >Express post</option>
  </select><br/><br/>
  Problem and Reason <br/>
  <textarea name = "detail" id = "detail" style = "width:300px;height:80px;padding:5px;"></textarea>
 
 	<br/><br/>
 Input Your Attendance Password Here: 
  <label for="password"></label>
  <input type="password" name="password" id="password" /><br/>
  <br/>	
  <input type="submit" name="button" id="button" value="Confirm Save It" />
  <input type="hidden" name="job_id" id = "job_id" value = "<?php echo $this->jobId?>"></input>
  <input type="hidden" name="shop_name" id = "shop_name" value = "<?php echo $this->shopHead?>"></input>
<?php }else{?>
<br />

<table width="500" border="0" cellspacing="0" cellpadding="10" align="center" style="border:#603 1px solid;">
  <tr>
    <td align="center" bgcolor="#FEDADD"><?=$this->errorMessage ?></td>
    <td><a href="javascript:history.go(-1)">Back to last page</a></td>
  </tr>
</table>
<?php }?>
</form>
</body>
</html>
